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All
information given herein is strictly confidential and
will not be
re-distributed for any purpose other than for the specific
use intended.
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First
Name: |
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Last
Name: |
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Spouse's
Name:
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| Email: |
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| Day
Phone: |
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-
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Home
Phone: |
-
-
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Cell Phone: |
-
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| Best
Contact Time: |
9-Noon
1-4pm
6-9pm
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| IMPORTANT: We can only work with you if we
can talk to you on the phone. If you do not give us a phone
number that we can reach you at, then we have no choice but
to stop our efforts to contact you and explain the Credit
Defense League program. |
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State:
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Total Debt:
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| A
minimum of $30,000 in credit card debt is required to qualify
for our program. |
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Are you current
on your credit cards?
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| How much credit do
you still have available on your credit
cards?:
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